Prostate specific antigen (PSA) is a protein produced by the prostate gland and secreted into semen during ejaculation. While the name is inaccurate, PSA tests are still used to evaluate prostate health, although controversy surrounds their effectiveness in reducing mortality from prostate cancer. Other tests are used in addition to PSA tests to make an accurate diagnosis.
Prostate specific antigen (PSA) is a protein produced by healthy prostate cells in men. The protein produced in the prostate and secreted into the semen during ejaculation. A blood or urine test that measures levels of prostate specific antigen is used by doctors as a means of examining a man’s prostate health, along with other methods of assessment. The protein was first characterized in the 1970s and the PSA blood test was developed in the 1980s. The first commercial PSA blood test was released in 1986.
Prostate specific antigen is a type of protein called a glycoprotein, which means it contains a type of sugar chain called a glycan. This protein is produced by the prostate gland to be included in semen, the white fluid expelled from the penis during ejaculation. PSA, also known as semin and seminoprotein, improves sperm motility by liquefying semen. Additionally, the protein helps dissolve the mucus cap present in the cervix, which allows sperm to enter the uterus.
Since the discovery and characterization of the protein in the 1960s and 1970s, it has become clear that the common name for the protein, prostate specific antigen, is actually inaccurate. This is because the protein can be found in other tissues of the body and also in women. In addition to the prostate gland and semen, PSA has also been found in female ejaculate, amniotic fluid, breast milk, breast tissue, and salivary glands. Despite this, the PSA test is still valid for evaluating prostate health because levels of the protein are elevated in men who have prostate cancer and other prostate-related conditions.
There is some controversy surrounding the use of the prostate specific antigen test to assess prostate health. One reason is that elevated PSA levels aren’t just caused by prostate cancer. Only about a third of men who have a positive PSA test actually have prostate cancer. The prostate naturally enlarges with age, and other urogenital diseases can also cause prostate enlargement, so other tests such as physical examination and ultrasound are used in addition to the PSA blood test to make an accurate diagnosis.
Another aspect of the controversy is that some studies indicate that the PSA screening test is not helpful in reducing mortality from prostate cancer and that the long-term benefits to patients are uncertain. These studies concluded that extensive PSA screening results in unnecessary treatment for non-existent prostate problems, leading to chronic problems such as infections, erectile dysfunction and urinary incontinence. Many public and private medical organizations recognize these issues and suggest that men talk to their doctors about PSA screening to weigh the risks and benefits.
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